The article focuses on the ethical and moral issues raised by the participation of physicians in the execution process in the United States of America. Discussion centres on two main areas. Firstly, participation in the actual execution, particularly where the method is lethal injection; and secondly psychiatric assessment and treatment of inmates who are deemed not competent in law for execution. It is argued that as an execution is a harm, participation runs counter to the ethics of the medical participation and cannot be justified even on the basis of relieving pain. Treatment of incompetency is permissible in very limited circumstances. Although the assessment of incompetency is not theoretically ethical, practical difficulties may mean participation is justifiable. The issues are discussed in the light of various moral theories including utilitarian and retributivist punishment theories, and the idea of "a right to punishment."

Christina Michalos, MedicalEthics and the Execution Process in the United States of America, 16 Med. & L. 125, 126(1997).